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Pustular vasculitis of the hands.
A P Hall1, R J Goudge, H J Ireton
1Department of Dermatology, Austin and Repatriation Medical Centre, Heidelberg, Victoria, Australia.
The Australasian Journal of Dermatology
|November 26, 1999
Summary
This case study describes pustular vasculitis of the hands in a woman with systemic involvement. Early corticosteroid treatment led to rapid resolution of hand lesions and a lip pustule.
Area of Science:
- Dermatology
- Rheumatology
- Internal Medicine
Background:
- Pustular vasculitis is a rare inflammatory condition affecting the skin and potentially internal organs.
- Early diagnosis and appropriate treatment are crucial for managing systemic involvement and preventing complications.
Observation:
- A 64-year-old woman presented with painful, tense bullae on her hands, unresponsive to antibiotics.
- Initial investigations revealed neutrophilia, elevated inflammatory markers (ESR, CRP), and abnormal liver function tests.
- Histopathology confirmed a neutrophilic dermal infiltrate with vascular fibrin deposition.
Findings:
- The patient was diagnosed with pustular vasculitis of the hands with systemic involvement.
- Treatment with oral corticosteroids (prednisolone) resulted in rapid resolution of both cutaneous and systemic symptoms.
- A subsequent lip pustule also responded well to increased corticosteroid dosage.
Implications:
- This case highlights the importance of recognizing pustular vasculitis and its potential for systemic manifestations.
- Prompt initiation of immunosuppressive therapy, particularly corticosteroids, can be highly effective in managing this condition.
- Further research into the underlying mechanisms and optimal treatment strategies for pustular vasculitis is warranted.